title: Goodpasture's disease: molecular architecture of the autoantigen provides clues to etiology and pathogenesis.
abstract: OBJECTIVE
  Goodpasture's disease is an autoimmune disorder characterized by the deposition of pathogenic autoantibodies in basement membranes of kidney and lung, which induces rapidly progressive glomerulonephritis and pulmonary hemorrhage. The target antigen is the α3NC1 domain of collagen IV, which is expressed in target organs as an α345 network. Recent studies of specificity and epitopes of Goodpasture's autoantibodies and discovery of novel posttranslational modification of the antigen, a sulfilimine bond, provide further insight into mechanisms of initiation and progression of Goodpasture's disease.
  
  
  RESULTS
  Analysis of the specificity of Goodpasture's autoantibodies revealed a distinct subset of circulating and kidney-bound antiα5NC1 antibody, which is associated with loss of kidney function. Structural integrity of the α345NC1 hexamer is stabilized by the novel sulfilimine crosslinks conferring immune privilege to the Goodpasture's autoantigen. Native antibodies may contribute to establishment of immune tolerance to autoantigen. Structural analysis of epitopes for autoantibodies and alloantibodies indicates a critical role of conformational change in the α345NC1 hexamer in eliciting an autoimmune response in Goodpasture's disease.
  
  
  CONCLUSIONS
  Understanding of the quaternary structure of the Goodpasture's autoantigen continues to provide insights into autoimmune mechanisms that serve as a basis for development of novel diagnostic tools and therapies for Goodpasture's disease.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2372, USA. vadim.pedchenko@vanderbilt.edu
authors.forename: Vadim
authors.initials: V
authors.lastname: Pedchenko
authors.forename: Roberto
authors.initials: R
authors.lastname: Vanacore
authors.forename: Billy
authors.initials: B
authors.lastname: Hudson
mesh_terms: D019867:Anti-Glomerular Basement Membrane Disease / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000737:chemistry*; D000939:Epitopes; D006801:Humans; D011487:Protein Conformation
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D000939:Epitopes